Interview with Ramana, a Family Caregiver in India

Ramana Rajgopaul and I “met” in the blogosphere in November 2008 when he wrote in a comment here that he was “a caregiver of sorts.” I went to his blog, Ramana’s Musings, to investigate what he meant. His multigenerational family lives in Pune, India and he is most definitely a family caregiver!

I knew immediately I wanted to interview him, both to learn about caregiving in another part of the world, and to get a man’s perspective on caregiving. (In the U.S. where I live, statistics show that more women are caregivers than men.) Ramana graciously accepted the invitation to be “grilled” by me and I hope you enjoy our “talk” as much as I did!

So without further adieu, I’m very happy to introduce (right to left) Ramana Rajgopaul, his wife, Urmeela, and his father, Senior Rajgopaul.

Welcome to Tender Loving Eldercare, Ramana. Please tell us how and when you became a caregiver.

My present care giving experience started eight years ago when my wife had multiple cerebral and cardiac infarcts (or mini-strokes). Since physically she was enfeebled (weakened), any kind of surgical intervention was not advised and her life had to be ‘medically managed’. Since her memory function was affected, she was not capable of managing this by herself. I had two choices – to provide for a live in professional caregiver, which in India is quite common, or look after her myself. My wife decided the matter by completely rejecting the first option. I therefore gave up my lucrative career, retired from active corporate life and became her caregiver. She is completely dependent on me and gets paranoid if I am away from her for more than a few hours. Otherwise, she is no strain on me either physically or mentally.

In the most recent instance, my 91 year old father was living with my step mother in a town about 1500 miles south of where we live. When my stepmother passed away three months ago, he had no one to look after him and I got him over to come and spend the rest of his life with us. He does not need much looking after but does need to be provided with company, food on time, support when he goes out, etc. He is hard of hearing and I have to answer his phone calls and be at hand when visitors call on him.

What do your care giving responsibilities consist of on a daily, weekly or monthly basis?

Seeing that all possible comforts are provided — for example, seeing that there is always hot water available in the bathrooms, beds are made and their clothes laundered and shelved, wholesome and nutritious food is provided on time etc.

Seeing to proper administration of medicines in the correct dosage and on specified times.

Arranging for, and accompanying to pathology tests, Doctors’ appointments and arranging to fill in prescriptions.

Accompanying and urging physical exercise as advised by the physicians.

Answering and making phone calls to friends and relatives who wish to keep in touch with both of them.

Seeing that neither faces any embarrassment due to lapses in memory, particularly with respect to names and places.

Linda’s response: How do you manage to prevent embarrassment for both of them, Ramana? That doesn’t sound easy to accomplish.

By calling people by their names often while talking, taking over the conversation when they falter etc.

If you presently work (full or part time), how do you manage the time commitment involved in caregiving?

The little work that I do, I do from home. Mostly on the phone and with the computer and broadband connection, it is not too difficult to attend to both.

What are some ways your life has changed since you became a caregiver?

I have become tied to the home/city and have stopped my major social activities like visiting the club, attending and giving parties, social work, volunteer work etc. On the positive side, I get more time to read, solve crossword puzzles, blog and mentor a few young entrepreneurs.

What is the most challenging aspect of caregiving for you?

Just being around, wherever they are, home or outside the home.

What is the most rewarding or enjoyable part of caregiving for you?

The sense of joy, that I am able to do something for both of them.

What do you do to take care of yourself to prevent caregiver burnout?

I have not yet experienced it and doubt that I will in the foreseeable future.

Linda’s response: I hope that you are correct about this, and continue to remain aware that it could happen as time passes.

Yes, and let us hope that it does not happen. If it does, I shall cross the bridge when I come to it.

What, if anything, do you use for inspiration or motivation during the most difficult times? (Those times most caregivers have experienced — when you feel you just can’t do it anymore.)

I find the time to increase my meditation sessions.

Linda’s response: Do you increase your sessions in frequency or length? Can you explain to us in what way(s) meditation helps you?

Both. Meditation helps me to be more or less equanimous. I have been a meditator since 1978 and I follow the Buddhist technique of Vipassana. This technique enables the meditator to be in a state of equilibrium and increases his awareness levels. I find these applicable to me too. My blood pressure is below normal (100/80) as a natural consequence.

What is the best caregiving advice you’ve ever given? Received?

Giving care, ensure that you do not become a case needing care.

Linda’s response: This is excellent advice for all family caregivers. Unfortunately the caregiver often becomes ill or dies before their care recipient does.

I hope that it does not happen to me!

Linda’s response: I do not wish that on you or any caregiver. That is why we must remain vigilant about caring for our needs, too.

Can you talk about caregiving options in India vs. the US where I live? Do the majority of families have their Golden Oldies move in with them? If not, are there a range of facilities available for their parents to move to based on their level of functioning? For example, in California, there are a range of assisted living arrangements that Golden Oldies may select from if they do not move in with their children. They range from independent living, to some assistance, to board & care homes, dementia care, and nursing homes.

We have such facilities in India too. We also have relatively inexpensive live in professional caregivers who come from agencies on rotation. I personally would not like to expose my wife or my father to any such facility. Others do, and I do not think that it is bad, just that their compulsions may be different. At the end of the day, each of us has to make our choices. I am blessed in that, my problems started when I could afford to retire and provide the care needed by my wife. I was also physically and mentally capable of doing that. Not everyone is so lucky.

By and large however, in India, Golden Oldies living with their offspring is the rule rather than the exception.

Linda’s response: I salute your self-knowledge and positive attitude about your decision. Being grateful for what we have is sometimes difficult for caregivers to do.

Thank you.

Are there any other cultural differences about family caregiving that you observe from your perspective, Ramana?

None whatsoever. Let me illustrate. My sister’s father in law and mother in law both needed care. My brother in law is their only son. In our culture, parents normally do not stay with daughters. My sister gladly did what was needed and when my mother, during her last stages, needed to be provided care, she gave it to her too with the total support and assistance from her husband. Very similar to what you and your family are doing.

I do not think that human beings can be culturally different when it comes to being human. The more I come across other care givers, the more I am convinced that language, religion, nationality or any other categorization, can make someone different in this particular aspect.

Linda’s response: This is beautifully written, Ramana! You’ve taught me that no matter where we live geographically, nor what gender we are, it’s the shared human experience that connects caregivers throughout the world. Thank you for telling us your unique caregiving story. Your wife and father are very blessed to have you caring for them! I wish you and your whole family many more years of love and joy!

Please leave your comments and/or questions for Ramana Rajgopaul or me below.

Read more about Ramana’s world and thoughts on his blog, Ramana’s Musings, or subscribe to his RSS feed here. I love his intriguing tag line “Wisdom by Hindsight.”

UPDATE: On March 15, 2009, Ramana wrote this message on his blog:

I have the sad responsibility of informing my readers of the unexpected passing away of my wife Urmeela on March 13, 2009.

The end was sudden, painless and I was with her when she passed away.

A measure of her universal appeal was at her cremation, Hindus, Catholics, Protestant Christians, Sunni Muslims, Shia Muslims and Atheists were present to bid her fond farewell.

None of us have the slightest doubt that her soul will rest in eternal peace.

You can see a beautiful photo of her and read the loving tribute Ramana wrote about Urmeela here.  My deepest sympathy goes out to you, Ramana, your son, Ranjan, and your entire family!  May her memory be a blessing.

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If you are a family caregiver and would like to be considered for an interview, please use the contact form available above. Thank you!